EBOLA SCRIPT


00:07
NARRATOR: Guinea. The first country to contract Ebola, the epidemic that has ravaged West Africa for the past nine months. It is the most severe outbreak of this disease since the virus was discovered forty years ago in the Congo.

00:30
NARRATOR: We travel to Gueckédou, to learn how this disease has managed to spread so rapidly throughout this entire region. The prefecture, in Guinea’s densely forested region, lies on the border between Liberia and Sierra Leone, and is at the centre of the epidemic.

00:51
NARRATOR: The boomtown of Guéckédou has a population of over 220,000. The Kissi ethnic group represent the majority here, speaking the Kissi and Malinké dialects, as well as French. Arriving here, it is clear the town is gripped by fear.

01:08
FIRST MAN: At the moment, the authorities here are telling us that the problem with Ebola is everywhere, and so we need to stay at home. Even at the market, there are cases, you know, it’s nothing like ever before.

01:27
SECOND MAN: Our prefecture of Guéckédou is being targeted as an Ebola region. What is really bothering us is that everything we do has been put on hold. Public services have been put on hold, all the offices are shut, just because of Ebola. So, that brings a bad reputation to the area.

01:47
NARRATOR: A bad reputation that Guéckédou could do well without. But a few months after the appearance of the first cases in neighbouring villages, Médecins sans Frontières decided to open their first treatment centre here six months ago.

In June, the NGO had considered shutting the centre, as the epidemic appeared to be under control. But a new outbreak of cases in July changed things dramatically.

This makeshift hospital is no longer big enough, and has had to hastily recruit temporary staff to face up to the growing number of cases in the eastern region of the country.

02:41
WORKER: Here’s the tent, the new tent, we can put at least eight patients in here. Eight patients. Each patient has two buckets, one for vomit and one to go to the toilet in. We change the sheets often, but if the patient excretes or vomits in the sheets we can’t clean them, we burn them straight away.

03:15
CAROLINA: Unfortunately the only organisation able to put up treatment centres now is MSF, and we can’t do it all. There need to be other organisations that are here, training people and putting up treatment centres. We never thought that it would be this big, or that its scope would make this epidemic such a huge problem. It requires so many resources, and we don’t have enough.

03:45
WORKER: Move, move!

03:49
NARRATOR: All these efforts are not enough, and the rain certainly doesn’t help. It’s 7pm, and the day’s work still isn’t finished.

04:02
NARRATOR: Ambulances are already arriving with seventeen new patients on board. Seventeen in one go is extremely high, and so the centre has to improvise in order to treat them.

These patients have arrived from the neighbouring town of Macenta, a hundred kilometres away, having driven for four hours on bumpy roads to get here.

At this stage, they are all suspected of having come into contact with Ebola. The utmost precaution is essential. Only the hospital staff suitably protected can approach the patients and touch them. The virus is spread by direct contact with the bodily fluids of someone who has been infected and has symptoms of the disease, such as fever, diarrhoea, vomiting and headaches.

04:52
NARRATOR: This tent is just for suspected cases. The new arrivals spend their first night here, waiting for the results of their screening test.


05:18
NARRATOR: The next morning, the day team is briefed by the night team. They must first count the new arrivals, and separate the suspect patients from those who have already tested positive. Those with positive results must then be placed into an area for confirmed cases.

05:47
DR MODET: Firstly, we have to start from the beginning, we return the confirmed patients and move the suspects towards the room of the confirmed cases. Who’s going to go about moving them there?

06:06
NARRATOR: Dr Floribert Lomboto is Congolese, and is a long-term worker with MSF. This morning he is dealing with the suspected cases that arrived last night. Above all, the teams must avoid contamination. It’s a long and gruelling process, done under close supervision. Not even a square inch of skin must be exposed. In line with strict procedure, multiple pairs of gloves, a mask, a body suit and an apron must be worn. This is a task that the medics carry out several times a day, since it is difficult to work in these clothes for more than an hour.

06:47
NARRATOR: We weren’t allowed into the high-risk areas where the patients stay. However, Dr Lomboto agreed to take in a camera for us and film his work, with the permission of the patients.

07:19
NARRATOR: His first consultation is with a family who arrived the night before - a young boy, accompanied by his mother and grandmother. It is not uncommon to see several members of the same family arrive together, having been contaminated by each other.

07:43
FLORIBERT (off-camera): The child can’t be there, he can’t be with his mother here. Go over there.

07:56
NARRATOR: The two women are in a critical state. They were probably not quick enough in getting to the treatment centre. While waiting for the screening test results, the doctor searches for clinical symptoms of Ebola, such as fever, abdominal pains and stiff necks.

08:16
FLORIBERT: The child is in a stable condition. Kilkili, over there, is in a bad state.

08:35
FLORIBERT: There isn’t a drug to treat the virus. Some patients are cured by immune recovery, by an immune reaction, and at the same time by the treatments of symptoms that we give, which stabilise the imbalances brought about by the virus.

The people who die are those who hang about, who come along already having major complications. But the people who come here a bit earlier are mostly cured.

09:17
NARRATOR: The grandmother of the family died during the consultation. The young mother will not survive either, but her child will be cured after spending a few days in the centre.

09:42
NARRATOR: Blood samples from new patients are taken to these experts at an EU mobile laboratory. Christopher Logue is an English virologist. He is working here as a volunteer, just like the MSF volunteers.

10:03
CHRISTOPHER LOGUE: So inside here we have another box, and inside that box, we have tubes, and inside those tubes are our samples.

10:14
NARRATOR: Christopher and his colleague need to abide by strict precaution measures, since the samples they are handling are extremely dangerous. Most of them probably contain the Ebola virus.


10:32
NARRATOR: Despite the poor condition of the site, they use the same safety protocols as a high security laboratory.

10:47
CHRISTOPHER LOGUE: Because of the nature of how highly pathogenic they are, every time that somebody works in the cabinet, we have what’s called a buddy, a buddy system and the buddy works with the operator, to go every step together so that we know that every step is done safely and there is no potential for accidents.

11:10
CHRISTOPHER LOGUE: As routine we don’t test people until they are showing clinical signs of an Ebola infection, so vomiting, diarrhea, high temperature, because then you have to test everybody and we don’t have the infrastructure here to do that.

11:27
CHRISTOPHER LOGUE: The conditions they are not like we are used to in our own labs, in England or in Germany, but we have made it as close to that as possible, so it’s, like this morning I said, when you we test samples, you get this negatives, it’s just a really good day, then you know that these people are negatives. When you have a child and it’s positive it’s a bad day. So it’s ups and downs.

12:00
NARRATOR: For the volunteers, moments of respite are short. Only a few hours are spent in the centre here, or back in their accommodation. Even if they are used to emergency missions, nothing could have prepared them for Ebola. Nobody can touch each other, and everybody keeps well apart. The virus is on their minds, all the time.

12:38
NARRATOR: Michel Komano is an MSF nurse, and his colleague Cécile Millimouno is from the Red Cross. These two medical workers do not spend their days at the patients’ bedsides. They work on the ground to try and contain the epidemic. Day after day, they travel through villages where deaths from Ebola have been reported. They are heading to the village of Kolo Bengou, one of the very first places to be hit by the virus.

13:14
MICHEL: It was a very hostile village, and it was very hard to get a foothold there. The community did not cooperate with MSF, because rumours run rife throughout these communities. For example, they said that if a patient is taken, they go to the centre and we kill them. So it’s very difficult.



13:44
MICHEL: The issue is that they don’t know. They knew nothing about this illness or the reasons why they didn’t know about the illness, and so that’s why they’re scared.

13:58
MICHEL: There have been 25 deaths here, but since then MSF has come back here. We’re thanking God today.

14:07
MICHEL: In this community, when someone falls ill you need to go and visit them, greet them, pamper them, and reassure them that they’re not alone. We’re really all in this pain together, and that’s what custom dictates that we do. Ebola is a disease through contact, and there are lots of contaminations. If they just fell ill, there would be no assistance, because they weren’t cooperating.

14:34
NARRATOR: Trust can only be established if patients accept being treated by MSF. Or when some of them return to their village cured, like this young mother.

14:46
CECILE MILLIMOUNO: Fortunately for us, she arrived at the centre in good time, and she was able to be cured. So now we have to follow up with everyone else who was with her.

15:03
NARRATOR: Michel and Cécile’s work involves tracking down all those who have been in contact with a patient or somebody who has died from the virus. That is the case with this family, having lost one of its parents to Ebola.

Each member of this family has had check-ups on a daily basis for 21 days – which is the incubation period of the virus. If one of them had displayed the slightest symptom, they would have been transferred to the MSF treatment centre in order to avoid contaminating the village.

15:48
They are happy today because they have finished their observation period. None of them tested positive.

This village has been hit hard by Ebola. Dozens of children have been orphaned, and the loss has taken away from the workforce in the fields, impacting on the economic survival of those who remain. These are just some of the reasons why following up with patients is so vital, and requires such a large taskforce.

16:19
NARRATOR: In the towns and cities, too, like here in Guéckédou, huge prevention projects are being undertaken. Motor-taxi drivers are the first focus group, since they are one of the most exposed.

Faya Antoine attended MSF’s first prevention meeting.

16:44
FAYA ANTOINE DOUFANGADOUNO: They told us to avoid touching Ebola victims because this virus is very dangerous.

16:54
INTERVIEWER: How do you know if someone is infected before they get on to your taxi?

16:59
FAYA ANTOINE: I have chlorine, and before getting onto my bike I have to keep it hygienic – the place where the passenger sits – and I put myself first. I wash my hands thoroughly with chlorine, and you too should wash your hands with the chlorine. I’m afraid, because you know, it’s a very dangerous virus, and we should be afraid of it.

17:36
NARRATOR: For now preventions like this have been successful in Guéckédou, after months of hard effort. But it has not been enough, either in quantity or speed. The epidemic can be contained one moment, but break out again the next.

17:52
MARC PONCIN: We’ve never seen such a broad epidemic, we’re discovering new cases every day. So we’re behind, we’re constantly behind. And every time we feel that it is under control, there will be a new situation which overtakes us. It’s not that we’re running behind the epidemic, it’s that the epidemic is running away ahead of us. It’s sad. Before, epidemics that we’ve seen have been in relatively remote areas where people didn’t move, and so the virus didn’t spread outside of these areas. In the three countries around what we call the ‘Parrot Beak of Guinea,’ that is, the borders with Sierra Leone and Liberia, the same ethnic groups live there. People there don’t respect the borders, they move about, and often have their field on one side of the border while they live on the other. So all three countries are affected by the epidemic in more or less the same way.

19:05
NARRATOR: Macenta, a nearby town, has recently flared up with the epidemic. The situation here is very unstable. The people are poorly informed, and scared of the sudden peak in cases. This is the hospital where the very first cases of Ebola were treated back in February. The director of the hospital from that time has since died from the virus.

19:29
DR SAVANE: As a generalist, we used to carry out our consultations barehanded. Nobody said anything about Ebola, but if you aren’t used to a disease and you don’t see it regularly, then to be honest it can pass by unnoticed. Then people started to come. And when they’re coming now, first of all the resources are being depleted. And it’s an issue, because they see that we have to wear gloves and take other measures. Now, we need to gear ourselves up for how we can deal not only with other illnesses, but also with suspect cases that turn up.

20:09
NARRATOR: The hospital is simply not equipped to fight an epidemic like this. They lack even the most basic protection material, not to mention treatment resources.

20:19
MARC PONCIN: With as many medical workers who keep on getting infected, it’s really dramatic and a real problem. But it’s partially as a result of poverty, under-development and the lack of rigour that these countries can have.


20:40
NARRATOR: To help out, this MSF hospital has set up a centre to pick out suspected cases. Any confirmed cases are then transferred to the MSF treatment centre at Guéckédou.

In this hospital, a nurse has just died after treating her patients. Her family is not allowed to go near her, since only the Red Cross is permitted to prepare bodies for high-security funerals. Also, an emergency health announcement has formally forbidden the movement of bodies between localities.

21:18
DR KEITA: The precautions that we are placing on the corpses are very, very important. Corpses are more infectious than living people. When a person is alive, the virus remains on the inside of the body, and not the outside, but when the person has passed away, the virus comes to the surface of the skin.

21:43
NARRATOR: For the families, it is not easy to abide by these new practices. There have been numerous protests, since custom dictates that funeral preparations should be carried out by the close family of the deceased. Often, their body is even taken from one village to another, so that whoever knew the person can pay homage to them.

22:05
DR KEITA: There are rumours going around that we come along, take out their eyes, take out their tongue, suck out their blood, remove their organs and send them away to be sold. And that it is all a conspiracy among white people. They also say that the chlorine we use for disinfection contains the virus, and so when we disinfect a house we leave the virus there, and the next day the people fall ill. And at times they even make me put my finger in the chlorine and then place it on my tongue, so that they can truly understand that it’s not a deadly toxic substance, but that you can even ingest small amounts of chlorine.

22:45
DR KEITA: Lift it up, lift it up, don’t pull, lift it up

22:51
NARRATOR: For the family, on top of the pain of losing a loved one, there is a long period of uncertainty and worry.

23:00
BROTHER: They said ‘have you touched your mum?’ And I said ‘yes.’ While she was being taken away she could walk, and she did walk a bit, but they took her – she was wearing long sleeves – they took her by the shoulders and made her sit. This was when it was raining. When they made her sit down they washed their hands with soap, and then with chlorine, and then again with the chlorine. That’s when they touched her, and apart from that they didn’t touch her.

23:30
NARRATOR: Understandably, the parents are anxious to know if one or the other of them is infected.

23:38
BROTHER: So now you’re being tested. What assurances can you give us?

23:44
OTHER MAN: We’re in a battle – I like to say that it’s like we’re at war. This is what I’ll advise you: when you know the signs, and most of you know the signs, if you take yourself as soon as possible to the centre then you’ll have a high chance of getting cured. If you don’t go there, you’ll contaminate other people and then people close to you. Then you make the chain grow longer and you endanger the whole village, or even the whole country, because then other people will come into contact with them, and you’ve seen what that does. Don’t let Ebola just pass you by.

24:36
NARRATOR: In Guéckédou, patients are still continuously flowing through the centre. Some of them turn up of their own accord, right from the first symptoms, like this woman. This is a sign that the prevention campaigns are paying off. But progress is slow.

24:52
NARRATOR: In the neighbouring tent, doctors are faced with a new crisis situation.


25:16
NARRATOR: A young woman has just died in the tent for confirmed cases. The team must urgently disinfect and remove her body. She has left behind a child barely one year old. The little girl also lost her father just a few days ago.

25:42
DOCTOR: The daughter is suspected as well, but she doesn’t display symptoms. The mother decided against leaving her daughter with the suspect cases, she said that she would keep her at her bedside but then she died when she had been hospitalised. For the moment, the child doesn’t show any signs that hint at Ebola. She was in contact with her mother right up until she died, so we think that she could have the virus.

26:16
NARRATOR: For the medical staff, this kind of situation is always hard to manage.

26:34
LAMBERT KONDIANO: The patients come here already in critical states, and we just have to take them in. It happens a lot. It’s hard, but we just have to take them in, mainly so that we can save the children.

26:50
NARRATOR: Only a few days later the orphaned girl also died of the virus.

27:05
CAROLINA: We are trying to do some follow-ups occasionally, if people don’t feel okay or want to talk, et cetera. We have foreign psychologists, so they regularly have the opportunity to talk and meet up with them. We try to be there so they can talk with us, and get support.

27:40
MARC PONCIN: Today, we have two centres in Guinea, two in Sierra Leone, and two in Liberia. All our experts are on the case. We have to take risks by making people who are less qualified than in the past come in. It increases our capabilities, but it’s still not enough. And unfortunately no other medical organisation is equipped yet.

28:10
NARRATOR: Dealing with an Ebola crisis is certainly hard work. Every movement has to be made with the utmost care to avoid contaminations. For people who die inside the treatment centre, a makeshift morgue has been made to prepare the bodies, before the Red Cross can transport them to the cemetery. This all has to be done with respect to the dignity of the deceased. Each death is documented, and a photo is presented to their family.

29:08
INTERVIEWER: Are you afraid for your own health?

29:15
NESTOR OUENDENO – HYGIENIST: Even if we are scared, with the protection measures that we abide by – and we abide by them really closely – I think we can’t say we’re 100% safe, but instead we’re about 98% safe.

29:36
NESTOR OUENDENO – HYGIENIST: I’ve been here for five months now. Sometimes I wonder when Ebola will ever end. That’s the question that’s eating away at me every time my head hits the pillow. That’s all.